放大肠镜技术在大肠肿瘤性病变诊治中的应用  

Application of magnifying colonoscopy in diagnosis and treatment of colorectal neoplastic lesions

作　　者：王烨[1] 李志霞[2] 安大立[2] 韩加刚[2] 高庆云[1] 

机构地区：[1]首都医科大学康复医学院 [2]首都医科大学附属同仁医院外科,北京市100730

出　　处：《中国康复理论与实践》2005年第3期224-225,共2页Chinese Journal of Rehabilitation Theory and Practice

摘　　要：目的探讨应用放大肠镜鉴别及治疗大肠肿瘤性病变的价值。方法对61例患者的78个病灶进行染色后放大观察,按工藤分型进行了同步pitpattern诊断。镜下摘除或手术切除后,将放大肠镜诊断结果与组织病理诊断结果相比较,分析其一致性。结果放大肠镜诊断与病理诊断符合率为962%,敏感性为984%,特异性为857%。肠镜下对70个良性病变进行了同步微创治疗,并为决定其他8个病灶的治疗方案提供了重要依据。结论通过放大电子肠镜对病变表面的腺体开口形态进行观察、分型准确,是及时鉴别大肠病变中肿瘤与非肿瘤的良好诊断方法。利用内镜可以完成对绝大部分病变的同步、微创治疗。ObjectiveTo evaluate the clinical value of magnifying endoscopy in diagnosis and treatment of colorectal benign neoplastic lesions.Methods78 colorectal lesions in 61 patients were examined with magnifying colonoscopy after indigo carmine dye, and a pit pattern diagnosis was made for every lesion according to Kudo's classification.All the lesions were totally resected, and the specimen were sent for pathologic examinations.ResultsThe diagnostic sensitivity of neoplastic lesions was 98.4% and specificity was 85.7% when types Ⅰ and Ⅱ represented the pit pattern of nonneoplastic lesions, whereas types Ⅲ, Ⅳ, and Ⅴ represented adenoma and early colorectal cancer. The overall accuracy in differentiating adenoma and early colorectal cancer from nonneoplastic lesions was 96.2%.94.5% of adenomarous lesions were treated by colonoscopy.ConclusionThe magnifying colonoscopy can provide an instantenous accurate diagnosis of tumorous lesions in colon and rectum. Synchronize, minimally invasive and curative treatment is possible to be completed by using it for a large number of lesions. [

关 键 词：放大肠镜 结直肠肿瘤 诊断 治疗 腺管开口类型 病理 

分 类 号：R735.3[医药卫生—肿瘤]